1. CD19 Cell Count at Baseline Predicts B Cell Repopulation at 6 and 12 Months in Multiple Sclerosis Patients Treated with Ocrelizumab
- Author
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Girolama Alessandra Marfia, Giuseppina Miele, Giacomo Lus, Doriana Landi, Rosanna Missione, Paola Cavalla, Maddalena Sparaco, Paola Valentino, Luigi Lavorgna, Simona Bonavita, Gianmarco Abbadessa, Antonio De Martino, Elisabetta Signoriello, Marco Vercellino, Chiara Bosa, Abbadessa, G., Miele, G., Cavalla, P., Valentino, P., Marfia, G. A., Signoriello, E., Landi, D., Bosa, C., Vercellino, M., De Martino, A., Missione, R., Sparaco, M., Lavorgna, L., Lus, G., and Bonavita, S.
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Every Six Months ,Health, Toxicology and Mutagenesis ,Cell ,Settore MED/26 ,Antibodies, Monoclonal, Humanized ,multiple sclerosis ,Gastroenterology ,Article ,CD19 ,03 medical and health sciences ,0302 clinical medicine ,Multiple Sclerosis, Relapsing-Remitting ,ocrelizumab ,Internal medicine ,Multiple Sclerosi ,medicine ,Humans ,CD20 ,Lymphocyte Count ,B cell ,Kinetic ,B-Lymphocytes ,medicine.diagnostic_test ,biology ,business.industry ,Multiple sclerosis ,Public Health, Environmental and Occupational Health ,B-Lymphocyte ,Magnetic resonance imaging ,medicine.disease ,030104 developmental biology ,medicine.anatomical_structure ,kinetics ,biology.protein ,schedule ,Medicine ,Ocrelizumab ,business ,030217 neurology & neurosurgery ,medicine.drug ,Human - Abstract
Background: The kinetics of B cell repopulation in MS patients treated with Ocrelizumab is highly variable, suggesting that a fixed dosage and time scheduling might be not optimal. We aimed to investigate whether B cell repopulation kinetics influences clinical and radiological outcomes and whether circulating immune asset at baseline affects B cell repopulation kinetics. Methods: 218 MS patients treated with Ocrelizumab were included. Every six months we collected data on clinical and magnetic resonance imaging (MRI) activity and lymphocyte subsets at baseline. According to B cell counts at six and twelve months, we identified two groups of patients, those with fast repopulation rate (FR) and those with slow repopulation rate (SR). Results: A significant reduction in clinical and radiological activity was found. One hundred fifty-five patients had complete data and received at least three treatment cycles (twelve-month follow-up). After six months, the FR patients were 41/155 (26.45%) and 10/41 (29.27%) remained non-depleted after twelve months. FR patients showed a significantly higher percentage of active MRI scan at twelve months (17.39% vs. 2.53%, p = 0,008). Furthermore, FR patients had a higher baseline B cell count compared to patients with an SR (p = 0.02 and p = 0.002, at the six- and twelve-month follow-ups, respectively). Conclusion: A considerable proportion of MS patients did not achieve a complete CD19 cell depletion and these patients had a higher baseline CD19 cell count. These findings, together with the higher MRI activity found in FR patients, suggest that the Ocrelizumab dosage could be tailored depending on CD19 cell counts at baseline in order to achieve complete disease control in all patients.
- Published
- 2021